国家神经系统疾病临床医学研究中心数据管理与共享系统
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
CO2 combining power and outcomes in patients with acute ischaemic stroke or transient ischaemic attack
第一作者：Anxin Wang
通讯作者：Yongjun Wang
基本信息
- 负责人：Anxin Wang
- 数据来源： CNSR-Ⅲ
- 论文编号：CNSR-Ⅲ20200082
- 发表时间：2020-12-09
2020-12-09
已发表文章
发表杂志：Stroke & Vascular Neurology
发表类型: Original Research Article
影响因子(IF): 4.765
PMID: 33298534 Pubmed原文链接 全文下载
主要研究背景及目的
Carbon dioxide combining power (CO2CP) is a measure of alkali reserve, and can help in the diagnosis of the metabolic type of acidosis and alkalosis. The determination of CO2CP basically represents the amount of alkali reserves in blood, and determines whether there is acid-base disturbances and its degree. Decreased CO2CP has demonstrated to be an indicator of metabolic acidosis in non-respiratory patients. Previous studies found metabolic acidosis was associated with insulin resistance, hypertension, inflammation, activation of renin-angiotensin-aldosterone system (RAAS), and endothelial dysfunction, which could contribute to adverse clinical outcomes after stroke. Furthermore, acidosis is common and has been proved to be associated with poor outcomes of ischemic stroke. Herein, it is logical to consider CO2CP as a risk factor for poor outcomes of stroke.
方法
Data were derived from the China National Stroke Registry III. Patients were classified into five groups by quintiles of CO2CP levels and three groups according to the normal range of CO2CP (23–29mmol/L). Multivariable Cox and logistic regressions were adopted to explore the associations of CO2CP levels with all-cause death and poor functional outcomes (modified Rankin Scale (mRS) 3–6/2–6) at 3 months and 1 year.
结论
Decreased CO2CP was associated with high risk of all-cause death and poor functional outcomes in patients with AIS or TIA.
主要结果
Among 9531 patients included in the study, the median (IQR) CO2CP was 24.9 (23.0–27.0)mmol/L. After adjustment for potential confounders, patients in the first CO2CP quintile (21.1–23.3mmol/L) had higher risk of allcause death and poor functional outcomes (mRS score of 3–6/2–6) (HR or OR with 95% CI 2.37 (1.32 to 4.25), 1.49 (1.20 to 1.83) and 1.21 (1.03 to 1.42), respectively) compared with those in the fourth quintile. Similar results were found for outcomes at 1 year. Furthermore, all associations were also significant when CO2CP was <23mmol/L compared with CO2CP of 23–29mmol/L.